Abstract: FR-PO0532
Clinical Assessment of Sodium and Acid-Base Balance with the Neokidney Sorbent-Based Portable Hemodialysis Device
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Ficheux, Maxence, Centre Hospitalier Universitaire de Caen Normandie, Caen, Normandy, France
- Bolhuis, Dian Petra, Universitair Medisch Centrum Utrecht, Utrecht, UT, Netherlands
- Conan, Christophe, Nextkidney BV, Bussum, NH, Netherlands
- Bluechel, Christian, Nextkidney BV, Bussum, NH, Netherlands
- Gerritsen, Karin G., Universitair Medisch Centrum Utrecht, Utrecht, UT, Netherlands
Background
The Neokidney is a compact (13 kg), portable device developed for Short Frequent Hemodialysis (SFHD). It uses a sorbent-based system to regenerate dialysate, requiring only 4.5 L of fluid. In contrast to older systems such as REDY, which struggled with sodium control, Neokidney aims to provide precise isonatraemic dialysis. This report analyses sodium and acid-base balance during Neokidney therapies conducted as part of a safety and efficacy study at the Caen University
Methods
This prospective, single-arm, first-in-human trial was conducted between March and June, 2024. Four adult SFHD patients received 4–8 Neokidney sessions over a 3-week period, with exposure gradually increased to up to 5 consecutive sessions per week. Two baseline sessions using standard SFHD machine were included. Blood samples were collected pre- and post-dialysis; dialysate samples were taken at defined intervals.
Results
A total of 25 Neokidney treatments were performed without device-related serious adverse events. Dialysate sodium concentrations adapted to plasma levels within 30 minutes and remained stable, providing consistent isonatremic dialysis. Plasma sodium stayed approximately unchanged during sessions (median [Q1–Q3] change: −1.0 [−2.0–0] mmol/L with Neokidney vs. +1.5 [1.0–2.3] mmol/L at baseline). No cumulative effects were seen across sessions; pre-dialysis sodium levels remained stable.
The dialysate buffer concentration (bicarbonate + lactate) stabilized within 30 minutes at levels correlating to the patient’s pre-dialysis plasma concentration. Plasma buffer concentrations during Neokidney sessions slightly reduced (-2.7 [-4.0–-1.2] mmol/L) vs. a rise during baseline (+7.1 [6.5–8.0] mmol/L). Plasma pH was stable or slightly increased (0.02 [-0.01–0.04]) during Neokidney and baseline (0.01 [-0.01–0.04]). While acid-base balance remained approx. unchanged per session, a slight downward trend in pre-dialysis buffer and pH was noted over repeated treatments.
Conclusion
Neokidney showed promise as a safe, effective SFHD system.. Dialysate sodium remained stable throughout all therapies. Acid-base data suggest buffer supply was insufficient to correct patient’s underlying metabolic acidosis across multiple sessions. This will be addressed by increasing dialysate buffer via partial chloride–lactate replacement.